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Low-dose brachytherapy effectively treated facial mycosis fungoides lesions
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Treatment with low-dose, high-dose-rate brachytherapy using custom-made surface molds effectively treated facial lesions in patients with mycosis fungoides, according to study results.
Jennifer A. DeSimone, MD, director, Cutaneous Lymphoma, Washington Cancer Institute, and clinical instructor, Georgetown University/Washington Hospital Center Department of Dermatology, Washington, D.C., and Emmanuella Guenova, MD, PhD, research fellow, Department of Dermatology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, and fellow researchers treated 23 facial mycosis fungoides (MF) lesions in 10 patients (median age, 57 years; 60% women) with high-dose-rate brachytherapy. Therapy included two fractions with doses of 4 Gy per session using custom-molded surface applicators between Aug. 17, 2009, and March 12, 2012. Researchers designed the study to describe the levels of erythema, scale, and induration of facial lesions in MF before and after treatments and to assess clinical improvement after the procedure.
Jennifer A. DeSimone
Eight lesions were located on the cheeks; seven, on the periocular skin; three, on the nose; two, on the chin and submental area; and one each on the scalp, forehead and lip.
Partial (four patients, 10 lesions) or complete (six patients, 13 lesions) clearance was observed, with cosmetic outcome rated excellent by nine patients and good by the other. Median follow-up was 6.3 months, during which no recurrences were reported.
Emmanuela Guenova
Study limitations included lack of standardized or long-range follow-up data and small sample size, the researchers reported.
“The utility of brachytherapy in the treatment of facial lesions of MF is its safety and effective use on delicate facial skin,” the researchers concluded. “In our experience, low-dose brachytherapy using custom-made surface molds represents an excellent addition to the armamentarium of therapies in the management of facial cutaneous T-cell lymphoma.”
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